Bipolar Disorder is the core theme of “Crazy” by Pete Earley. Pete Earley has presented an in depth analysis of this particular sickness and the current rate of treatment that is available to deal with it. Bipolar Disorder is more than often referred to as a psychotic sickness ranging to the point of depression and mood swings (Kaysen et al, 2009). It is also commonly known as manic depression. Pete Earley, a Washington Post journalist has portrayed this picture through an observation of a screened patient. His son Mike was a victim to this sickness.
He went from institution to institution trying to get his son admitted for treatment. But he was told that as his son was an adult, till he did not attempt to hurt himself or somebody else or did not consent to treatment, he could not be admitted. All this came to an end, when Mike broke into a neighbor’s house simply to take a bubble bath. In the process he caused some interior damage and was arrested on the same grounds. This made things extremely difficult for Earley. He could not comprehend how his son would be treated if he was being submitted to the harsh reality of imprisonment. Therefore Earley visited various mental institutions and prisons out of which Miami Dade County jail was one. The jail housed over 3000 prisoners, out of which some were in an extremely sorry and continuously deteriorating mental state.
The main reason for their continued imprisonment was that the designated authorities failed to understand that the dangerous behavior was not meant to cause intentional harm but was actually a byproduct of their mental instability (Earley, 2006). This book gives us an insight into the lives of people suffering with manic depression, schizophrenia and other such mental illnesses that are mistaken for criminals and tried for serious crimes and felonies, when what they really need is proper medical treatment under supervision of specialists qualified in dealing with such cases.
The Earley Family
It is imperative that the state of mind of the patient is given regard when social work for the mentally ill is carried out. The social worker holds responsibilities that entail being a clinician to the patient and using continuously adapting therapy based on the evolving condition of the patient. It is necessary to determine exactly how the environment around the person is contributing to the person’s condition. Factors such as political, individual, community and family are more than often the primary contributors in this regard.
Being a social worker, I would dedicate myself to caring for him. The fact of the matter is that these sort of people need constant care and monitoring however they must not under any circumstances know that they are being monitored, this might induce and unsavory response from them (NASW, 1996). Mike managed to disappear and cause havoc, maybe because he was alone and unattended, that is what I will try to prevent. I will realize my position as Mike’s External Support System. It has been recorded that the probability of an individual’s death is very closely related to the size of the individual’s support system (Ray, 2004). Schizophrenia patients often tend to think that the world is trying to boycott them, this is just a sever case of depression and feeling low.
Therefore the remedy for this would be to keep the person amused by occupying him with something that interests him. Of course exceptions must be made for a victim of the above sickness as they tend to be moody and sullen and at times are happy go lucky, as if not bearing a care in the world. I will determine whether the patient is suffering from mental illness because of poverty, parental discord, physical illness, delinquency, foster care influences or past war stress and subsequently I will treat my patient especially in accordance to the individual knowledge I have of my patients. Patient-Centered Care in this scenario is of boundless significance (Ray, 2004).
As a social worker who is committed to the duties assigned to me, I will use the advantages of my personality to build upon the strengths of Mike’s personality. This will allow me to work upon his issues by utilizing the very potential that he holds. It will allow me to understand Mike as a complete person and it will enable me to respect Mike’s hopes and ambitions with the passage of time.
As a social worker, I would try to adapt myself to his mood swings, being there to listen if he wanted to talk. Manic depression calls for calming responses and must not be met with sullenness. For example a child, who cannot concentrate in class, will try to amuse himself by making jokes, this is not because he wants to, it’s because he wants attention, unknowingly he wants a person to stay with him, talk to him, and coax him. Brooding in loneliness is a definite negative in this case. It is of the utmost importance to realize that these patients feel completely alone and rejected, and it is therefore necessary that they be brought in to a state of mind where they can feel themselves to be a part of a Social System (HBSE).
The patient must never be left to his own devices. Just because he has mood swings that result in his attaining an attitude we would generally attribute to that of a sullen grouchy person does not mean that he must be punished by loneliness. There must be under all accounts someone to take care of him. If he feels an air of camaraderie around him there is a good chance he will eventually feel as if he is wanted (Cournoyer, 2003). I would try to become his friend, a confidant. I would be a person to him to whom he can convey his hallucinations to without feeling as if the world will erupt around him in anger, hostility or shock.
It would not be wrong to agree with the approach that Martinez has adapted to the Freire Methodology at this point. It is imperative that the social worker try to understand the state of mind from which the patient perceives the world. This is so because this perception contributes greatly to the correct way in which the patient is treated and since it involves social and cultural influences, it has a significant impact upon the self-confidence that the patient harbors.
For those who I know are the likes of whom we shall discuss further on, I will do all that is in my power to be warm, guiding and empathetic at all times (HBSE). I realize I will be required to understand that there will not be instances where I may lose control of my patient, however to avoid the occurrence of such circumstances will always be one of my topmost priorities. It is important to determine and differentiate between the patient’s perceived stress, negative affect, and the number of stressful life events that the patient has experienced in the recent years and is still capable of recollecting (Ray, 2004).
Freddie Gilbert and his environment
The author states that even though it is a well known fact that the entire populace of Miami does not have a roof on their head, it is speculated that the homeless and dislodged manage to find shelter that they can call home through one way or another, however, there is a small yet distinct number of people who continue to remain homeless, not because they do not manage to find one, but because they are incapable of finding one. Their inability to do so is not out of any desire or whim, but because they are mentally ill and cannot function to their fullest human extent. Freddie Gilbert is one of that few.
But before we delve into Freddie Gilbert’s case, we must understand that our society has evolved into one where we push the mentally weak into a situation where the only way in which the mentally ill can communicate with us is through reaction that is more than often based on taking effects upon themselves. Such people require that they be given a chance to put forth their perspective of the situation before any inference can be made regarding their position. Whether we choose to admit it or not, we are individually influenced by the orderly prevalence of the culture that dominates in our society.
Freddie Gilbert is one of the few people whose homelessness and desperation Pete Early traces in his book, “Crazy”. The author mentions Freddie Gilbert as one of the few who touched him the most.
When discovered by the state, Gilbert had been arrested on charges of being a public nuisance and causing disturbance. The saddening part we see is that the chain of arrest and untreated release has happened over 30 times before when the author comes to know of Gilbert. This consistent catch and release of the man served to aggravate him, and the fact that every time he was released, he was released untreated accounts for the further deterioration of Gilbert’s medical condition. It is necessary to understand at this point that the resiliency of a person suffers severely when exposed to such circumstances. In certain cases, the resiliency of a completely normal person would falter, Gilbert on the other hand was a patient of a chronic mental illness. Jails are designed to discourage inmates from ever wanting to be in jail again once they have been released. Such is the hostility of the atmosphere of jails. To a mentally ill person such as Gilbert, every trip to jail meant a blow to his already chronically ill mind. Gilbert was released within 24 hrs every time after he had been arrested, for a chronically ill minded person who has problems comprehending the world around him, this rapid changing of scenarios from captivity to helplessness must have been injurious to his state of mind. Perhaps that is why Gilbert came down to a level where he was caught in a revolving door at the time of the arrest when the author met him.
Upon considering the ecological model shown above, one cannot help but concentrate the present chain of occurrences rather than delving into the causes and reasons that led to it. To an effective social worker, the collection of events of the past is only an implication of the present. It is the present that is of primary significance. As Professor Ung noted that it is the present and the happening that is of topmost priority. Our actions should be based upon what is happening rather than what has happened. Of course, in this perspective, tangible and intangible events both deserve their individual due consideration (Ung, 2008).
For Gilbert, his micro and macro influences had brought him to a state where his mentally ill person decided to live out life in the back alley of a restaurant like an outcast animal. Environment came to Gilbert’s help when a reformist judge decided to put Gilbert in a rehabilitation program for a period of six months. Federal law did not allow Gilbert to be sent to a rehabilitation program, yet the judge must have observed a critical degree to have generated in Gilbert’s condition to have chosen to send Gilbert to a rehabilitation program. After six months, Gilbert looked like a new man and was capable of conversing normally and next came the need for the establishment of a Surrogate Family.
He was assigned to a group home, where he could rest and rehabilitate with the homely environment, yet, sadly, as soon as a month had gone by, Gilbert was eating out of a garbage can and was back to living in alleys once more. Unfortunately, there was no follow-up on Gilbert and how he was doing, and when Gilbert came back to the streets and began to live his deplored life once more, the only check of his state was possible when he was arrested again
The environment around Gilbert had found him, worsened him, tried to rehabilitate him, and when it failed to do so, it had left him once more where he had begun from (Johnson, 2004). Gilbert’s state of mind had brought him to his state where he was living on and off the street, but it was the environment around Gilbert that left him there and it was a miracle how the reformist judge decided to send Gilbert to a six month rehabilitation program, but sadly even that miracle of the environment did not manage to pay off.
A lesson to learn
When we look at people such as Freddie Gilbert and other people like him and the people that the author has mentioned in his book, it is people like Ted Jackson, April Hernandez and Alice Ann who show us what moral character our society truly possesses. Once cannot be but truly touched by the shocking state in which the chronically mentally ill remain on the streets through their lives and how our first world country was once in such a state of ignorance that these innocent minded people were left to live and die on the streets. The chronically mentally ill who more than often did not even know what they were doing and for the same reason could not even manage to attain and maintain a roof on their heads. Even with intervention from the environment, the personality characteristics that have been developed by the continuous deterioration of the mind continue to dominate.
The key, as we can infer, is not to create treatment channels for these people in the environment around them, but to make sure that the treatment they are given is of a continuous nature. This is because most of the times, by the time these people are found, their mental state has taken a significant toll on their bodies and their consciousness and their half-aware state of the world around them becomes their permanent state of mind through which they view the world and learn from the world.
Therefore, it is necessary that these patients be given constant attention. Since the illness will refuse to go away having become a strong habit, it will be necessary to slowly and steadily suppress and remove the illness. This process can take months and maybe even years at a time, but it is one that is of the utmost importance.
References
Cournoyer, Barry (2003). The Evidence-Based Social Work Skills Book. Allyn & Bacon.
Earley, Pete (2006). Crazy. Putnam Adult.
HBSE – Human Behavior and the Social Environment. Ecological Perspective.
HBSE – Human Behavior and the Social Environment. Ecological Development Approach.
Johnson, H. C. (2004). Psyche and Synapse, Expanding Worlds. Deerfield Valley Publishing. 2nd edition.
Kaysen, D., Resick, P., & Wise, D. (2003). Living in Danger: The Impact of Chronic Traumatization and the Traumatic Context on Posttraumatic Stress Disorder. Trauma, Violence, & Abuse. 4, 247-264.
The National Association of Social Workers. (1996). Code of Ethics (1st ed.) [Brochure]. Washington: NASW.
T. Ung, SW Practice 421-08 [lecture], 2008.
Ray, O. (2004). How the Mind Hurts and Heals the Body. Vanderbilt University.